What is phimosis or phimosis?
Phimosis or phimosis is a condition in which the upper skin of the penis called the foreskin becomes highly tight and does not retract from the penis (the front part of the penis called Glans in English). . Most children and infants who have not been circumcised have the problem of phimosis going forward, meaning that the foreskin of their penis does not fully or completely retract. This is because the penis and upper skin are interconnected for the first few years of the baby. Due to the non-retraction of the foreskin, the area under it is not cleaned properly and due to poor hygiene, there are frequent infections.
Repeated infection of the penis causes scarring (deep scarring) and results in the development of phimosis. People who have phimosis should contact a doctor as soon as they feel signs of an infection in the penis, signs and symptoms of infection include pain and swelling in the upper skin of the penis and bleeding pus, etc.
Children who have severe phimosis have persistent penis pain for several hours a day. The doctor examines the phimosis with the help of physical examination of the patient. The doctor can remove a sample of fluid or substance with the help of a swab from the area of the foreskin to check for urine infection and the presence of bacteria. Maintaining normal hygiene is very important to avoid infection and to reduce the chances of phimosis.
Treatment for the problem of recurrent phimosis includes applying steroid creams to the foreskin and performing surgery to remove parts of the foreskin or complete removal (circumcision) for a child 10 years or older. In children 10 years of age and older, if during urination, the urine first accumulates in the foreskin in the front of the penis and then slowly exits, they are subjected to surgery due to this problem.
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Symptoms of phimosis
Most of the baby boys who are not circumcised cannot retract their foreskin because their skin is still attached to the penis. It becomes completely normal within 2 to 6 years. Around the age of two, the foreskin begins to completely retract from the top of the penis.Phimosis does not always cause any type of symptoms, but when it is formed it usually causes symptoms like redness, swelling and pain etc.The tight foreskin may interfere with the passage of urine, affecting normal flow of urine. In severe cases, it also causes difficulty in emptying the bladder completely.
Diagnosis of phimosis
How is phimosis tested?
To test this condition, the doctor will ask the patient for his or her previous medical information, in which the gender or infection of the penis is first asked. They may also ask about the effect of any type of symptoms that occur during sexual activities. A physical examination is also done to check the penis and its upper skin.
It is usually easy to examine and the skin stuck behind the penis can look like a tight band.To test for phimosis, your doctor may ask you to have the following tests:The doctor may order a urine test to check for a urine infection.To detect the presence of bacteria, the doctor takes the sample with the help of a swab from the foreskin and tests it. Adults who have more tight upper skin have to undergo urine test and blood test to check their sugar level.
How is phimosis treated?
Normal phimosis in children usually does not require any treatment. It also heals over time. In this case, do not try to forcefully retract the foreskin as doing this causes scarring of the skin and increases the risk of developing phimosis abnormally in later life.
Personal hygiene is very important, which includes cleaning the underside of the foreskin daily, and if the skin can be retracted, it is necessary to clean it by retracting it. After cleaning, the skin should always be left on top of the penis.
Applying topical (steroid cream or gel etc.) medicines on the penis provides relief from this problem. This medicine should be applied twice a day and should be done for 2 to 4 weeks. Gently retract the skin as far as possible without causing any discomfort and apply a thick layer of cream on the tightest part of the skin. If this cannot be treated, then a powerful cream can be used. Sometimes treatment with steroid creams does not work.
Sometimes the condition of phimosis in the child is not treated this way. In such a situation, doctors suggest getting circumcised.
If the problem of phimosis persists even after 2 years, further treatment for this condition is considered. Further treatment is considered, especially if there is a frequent penis infection or urinary tract infection.
Plastic surgery or circumcision options
Circumcision is a surgical procedure by which the foreskin is removed. It is necessary to treat phimosis caused by injury etc. With its help, such phimosis is also treated which is due to repeated urinary tract or foreskin infections. Circumcision may also need to be done if your baby has trouble urinating due to phimosis. If the problem of applying phimosis is not cured with cream, then circumcision is considered. Sometimes parents themselves get their child circumcised after 2 years to protect themselves from future problems caused by phimosis.
For circumcision in young boys and children, a numbing drug (local anesthetic) is injected into their penis, which reduces the pain during the surgical procedure. Older boys or men who need to be circumcised are unconscious (general anesthetic) for this surgical procedure.
During surgery to remove the foreskin, the doctor holds the foreskin with a tool and carefully cuts the skin and separates it from the penis. The skin under the penis is stitched along the skin of the penis. The wound is covered with a piece of cotton wool filled with petroleum jelly or antibiotic ointment.
Plastic surgery options can also be used in place of circumcision. In this, one or more holes are pierced in the foreskin, which enables the foreskin to easily retract.